FDG-PET/CT Provides Clues on Bone Marrow Involvement in Follicular Lymphoma and Carries Important Prognostic Information

Jing, Yaoyao; Chen, Yafang; Yu, Yong; Zhao, Haifeng; Yang, Hongliang; Sun, Bei; Wang, Xiaofang

doi:10.7150/jca.87523

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J Cancer 2023; 14(14):2726-2738. doi:10.7150/jca.87523 This issue Cite

Research Paper

FDG-PET/CT Provides Clues on Bone Marrow Involvement in Follicular Lymphoma and Carries Important Prognostic Information

Yaoyao Jing^1,2,3,4†, Yafang Chen^6†, Yong Yu^2,3,4,5, Haifeng Zhao^2,3,4,5, Hongliang Yang^2,3,4,5, Bei Sun^1,2,3,4✉, Xiaofang Wang^2,3,4,5✉

1. Department of Day Ward, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China.
2. Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, China.
3. Tianjin's Clinical Research Center for Cancer, Tianjin, China.
4. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
5. Department of Hematology, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China.
6. Department of Hematology, The Second Hospital of Tianjin Medical University, Tianjin, China.
†These authors have contributed equally to this work and share first authorship.

Citation:

Jing Y, Chen Y, Yu Y, Zhao H, Yang H, Sun B, Wang X. FDG-PET/CT Provides Clues on Bone Marrow Involvement in Follicular Lymphoma and Carries Important Prognostic Information. J Cancer 2023; 14(14):2726-2738. doi:10.7150/jca.87523. https://www.jcancer.org/v14p2726.htm

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Abstract

Objectives: To compare the diagnostic efficacy of PET-CT and bone marrow biopsy (BMB) in the detection of bone marrow involvement (BMI) in newly diagnosed patients with follicular lymphoma (FL), as well as their prognostic implications in such patients.

Methods: Retrospective analysis was conducted on clinical data from 165 newly diagnosed FL patients. The benefits and drawbacks of PET-CT and BMB in assessing BMI in FL patients were compared and evaluated. Moreover, the prognostic outcomes and factors affecting the survival of FL patients were examined.

Results: Among 165 patients, bone marrow involvement (BMI) was diagnosed by PET-CT (PET⁺) in 54 cases (32.7%), by bone marrow biopsy (BMB⁺) in 50 cases (30.3%), and by either PET⁺ or BMB⁺ in 80 cases (48.5%). PET-CT scans upgraded 32 patients (19.4%) to stage IV, including 1 stage I and 4 stage II cases. Four patients were elevated to stage IV by BMB, all of whom had a previous stage III diagnosis. No patients with previous stages I or II were elevated to stage IV by BMB. The median follow-up time was 6.6 years (range,0-11.0 years). The 5-year OS was 86.7%, and the 5-year PFS was 44.8%. Multivariate analysis revealed that BMI by PET-CT was the only independent predictor of PFS reduction. Regarding OS, grade 3a and BMI by PET-CT were independent predictors of decreased survival.

Conclusion: PET-CT enables a thorough evaluation of bone marrow involvement in patients with FL, and BMI identified by PET-CT can have substantially implications for patient prognosis. PET-CT obtains vital data for the diagnosis, treatment, and prognosis of FL patients. By contrast, BMB seldom augments crucial data.

Keywords: PET-CT, bone marrow biopsy, follicular lymphoma, prognosis

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APA

Jing, Y., Chen, Y., Yu, Y., Zhao, H., Yang, H., Sun, B., Wang, X. (2023). FDG-PET/CT Provides Clues on Bone Marrow Involvement in Follicular Lymphoma and Carries Important Prognostic Information. Journal of Cancer, 14(14), 2726-2738. https://doi.org/10.7150/jca.87523.

ACS

Jing, Y.; Chen, Y.; Yu, Y.; Zhao, H.; Yang, H.; Sun, B.; Wang, X. FDG-PET/CT Provides Clues on Bone Marrow Involvement in Follicular Lymphoma and Carries Important Prognostic Information. J. Cancer 2023, 14 (14), 2726-2738. DOI: 10.7150/jca.87523.

NLM

CSE

Jing Y, Chen Y, Yu Y, Zhao H, Yang H, Sun B, Wang X. 2023. FDG-PET/CT Provides Clues on Bone Marrow Involvement in Follicular Lymphoma and Carries Important Prognostic Information. J Cancer. 14(14):2726-2738.

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